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Recent Updates

12/12/08: Questions about a RAC Demonstration Claim. If you have a question on a claim reviewed by a RAC during the RAC demonstration please e-mail CMS at the following address: RAC@cms.hhs.gov. Please do not send personal health information to this e-mail address. Thank you.

11/04/08:  Protest of RAC Awards and Automatic Stay  

The Centers for Medicare & Medicaid Services (CMS) is required to impose an automatic stay in the contract work of the four Recovery Audit Contractors (RAC) program.  This action is the result of protests filed by two unsuccessful bidders for the RAC program with the Government Accountability Office (GAO).

An automatic stay will stop work for all four RAC regional awards until a determination is made by GAO, as required under provisions of the Competition and Contracting Act of 1984 (CICA).  

Under the CICA, GAO has 100 days to issue its decision, which means a decision would be due for these protests in early February. The four RAC contracts – and any work under those contracts – are on hold pending the outcomes of the protests.



10/31/08: CMS Begins Provider Outreach in the 1st Wave States.

10/29/08: CMS Announces RAC Medical Record Request Limits. Click the link below to view the RAC medical record request limits and examples. 

10/10/08: CMS Announces RAC Contingency Fee Percentages. The RACs are paid a contingency fee; that is, the RACs receive payment based on the amount of the improper payments they correct for both overpayments and underpayments. Each RAC's contingency fee is established during contract negotiations with CMS and, as such, the contingency fee varies for each RAC. Click the link below to view the RAC contingency fees.

10/9/08: CMS Hires RAC Validation Contractor. CMS is pleased to announce it has contracted with Provider Resources, Inc, of Erie, PA, to work as the Recovery Audit Contractor (RAC) Validation Contractor.  The RAC Validation Contractor (RVC) will work with CMS and the RACs to approve new issues the RACs want to pursue for improper payments, as well as perform accuracy reviews on a sample of randomly selected claims on which the RACs have already collected overpayments.  The RVC is another tool CMS will use to provide additional oversight and ensure that the RACs are making accurate claim determinations in the permanent program.


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RAC Medical Record Request Limits [PDF,26.3 KB]
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RAC Contingency Fee Percentages

 

Page Last Modified: 12/12/2008 1:29:18 PM
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